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Continuous Parasacral Sciatic Nerve Block: Two Case Reports
  1. Gary F. Morris, FRCPC and
  2. Scott A. Lang, FRCPC
  1. Department of Anesthesia, Royal University Hospital, University of Saskatchewan, Saskatchewan, Canada
  1. Reprint requests: Dr. S.A. Lang, Department of Anesthesia, Royal University Hospital, 103 Hospital Drive, Saskatoon, Saskatchewan, Canada, S7N OW8.

Abstract

Objective This study investigated the use of a continuous parasacral sciatic nerve block for anesthesia and postoperative analgesia for lower extremity surgery.

Methods A continuous parasacral sciatic nerve block was performed in two patients (triple ankle arthrodesis and below-knee amputation). The sacral plexus was identified using an insulated Tuohy needle and a nerve stimulator. A catheter was placed near the elements of the sacral plexus via the Tuohy needle.

Results In both patients, surgical anesthesia was successfully established through the parasacral catheter with lidocaine 1% (1/200,000 epinephrine), and postoperative analgesia was successfully established with a bolus of bupivacaine 0.375% (1/200,000 epinephrine) and maintained with a continuous infusion of bupivacaine 0.1% (8 mL/h) for 48 hours.

Conclusion We conclude that continuous parasacral sciatic nerve block can provide anesthesia and long-term analgesia for operative procedures of the foot and leg.

  • regional anesthesia
  • local anesthesia
  • sciatic nerve
  • obturator nerve
  • saphenous nerve
  • sacral plexus

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